Anticipating the costs of assisted living is naturally a major fear factor for families prior to entering a facility. Once the move into the ALF has been secured, however, residents are happy knowing that their payment has been made and each month will continue to be the same. Unfortunately, in many cases that sense of relief quickly vanishes.

Imagine the shock of resident families only a few weeks or months later, when the rates skyrocket without warning. A bill may appear with charges for all kinds of  ‘miscellaneous services’ that the ALF staff decides have been incurred, from using extra staff time being helped to the dining room to spending too much time being helped out of bed. This rude awakening is what happens to residents who submit themselves to what is known as “a la carte pricing.”

The idea sounds innocent enough when presented to them before being admitted to the facility. Residents and their families are informed that the facility is able to offer a low-sounding initial monthly rate to them. However, it will be necessary for them to be “re-assessed” after a month or two to see whether they need more care than originally believed. Since most resident families tend to underestimate how much care their mother or father really needs, they willingly agree to this procedure without much thought.

What happens next is all too predictable. The “re-assessment” concludes that the new resident is in need of much more attention from staff than originally believed, and the pricing is adjusted upward to reflect this new finding. The upshot of this procedure is that the resident is now being billed an extra $1,000.00 per month, or more, for what many seniors find to be outrageous charges for small services like bringing a resident juice in the evening.

At facilities like Town Commons that charge only a fixed fee for monthly services, this scenario is believed to be unethical, and a major source of poor consumer relations. Although it is true of course that facilities are in business to make a profit, it is hard to believe that these a la carte pricing schemes cannot be adequately explained to seniors before their admission to a facility. But of course no one would actually volunteer for Sticker Shock if they knew what was about to happen to them in a few weeks!